Race, sense of control over life, and short-term risk of mortality among older adults in the United States

Shervin Assari

Introduction: Sense of control over life has been shown to have protective health effects in studies that have mostly enrolled White middle class individuals. It is unknown, however, whether populations differ in the protective health gain associated with sense of control over life. This study compared a nationally representative sample of Black and White older adults for protective effects of sense of control over life on short-term risk of all-cause mortality in the United States.

Material and methods: This longitudinal prospective study followed 1,493 White (n = 759) and Black (n = 734) older adults (age 66 or more) from 2001 to 2004. Race, demographics, socio-economics, sense of control over life, health behaviors, and self-rated health were measured at baseline in 2001. Outcome was all-cause mortality occurring between 2001 and 2004. Logistic regression models were used for data analysis.

Results: In the pooled sample, sense of control over life was protective against 3-year mortality risk above and beyond demographics, socio-economics, health behaviors, and self-rated health. We found a race by sense of control over life interaction, suggesting a stronger protective effect of control over life on mortality risk for Whites compared to Blacks. In race-specific models, sense of control over life at baseline was predictive of mortality among Whites but not Blacks.

Conclusions: In the United States, Black older adults do not gain a survival benefit associated with high levels of sense of control over life, as do their White counterparts. It is not clear why sense of control over life translates into survival for Whites but not for Blacks.